diff --git a/crates/typst-pdf/src/pattern.rs b/crates/typst-pdf/src/pattern.rs
index 965ce370a..906100665 100644
--- a/crates/typst-pdf/src/pattern.rs
+++ b/crates/typst-pdf/src/pattern.rs
@@ -1,7 +1,7 @@
 use ecow::eco_format;
 use pdf_writer::types::{ColorSpaceOperand, PaintType, TilingType};
 use pdf_writer::{Filter, Finish, Name, Rect};
-use typst::layout::{Abs, Transform};
+use typst::layout::{Abs, Ratio, Transform};
 use typst::util::Numeric;
 use typst::visualize::{Pattern, RelativeTo};
 
@@ -73,7 +73,9 @@ pub(crate) fn write_patterns(ctx: &mut PdfContext) {
 
         resources_map.finish();
         tiling_pattern
-            .matrix(transform_to_array(*transform))
+            .matrix(transform_to_array(
+                transform.post_concat(Transform::scale(Ratio::one(), -Ratio::one())),
+            ))
             .filter(Filter::FlateDecode);
     }
 }
diff --git a/tests/ref/visualize/pattern-simple.png b/tests/ref/visualize/pattern-simple.png
new file mode 100644
index 000000000..ac473a756
Binary files /dev/null and b/tests/ref/visualize/pattern-simple.png differ
diff --git a/tests/typ/visualize/pattern-simple.typ b/tests/typ/visualize/pattern-simple.typ
new file mode 100644
index 000000000..9c41067d5
--- /dev/null
+++ b/tests/typ/visualize/pattern-simple.typ
@@ -0,0 +1,18 @@
+// Tests that simple patterns work.
+
+---
+#set page(width: auto, height: auto, margin: 0pt)
+#let pat = pattern(size: (10pt, 10pt), line(stroke: 4pt, start: (0%, 0%), end: (100%, 100%)))
+#rect(width: 50pt, height: 50pt, fill: pat)
+
+---
+#set page(width: auto, height: auto, margin: 0pt)
+
+#let pat = pattern(size: (10pt, 10pt), {
+    place(line(stroke: 4pt, start: (0%, 0%), end: (100%, 100%)))
+    place(line(stroke: 4pt, start: (100%,0%), end: (200%, 100%)))
+    place(line(stroke: 4pt, start: (0%,100%), end: (100%, 200%)))
+    place(line(stroke: 4pt, start: (-100%,0%), end: (0%, 100%)))
+    place(line(stroke: 4pt, start: (0%,-100%), end: (100%, 0%)))
+})
+#rect(width: 50pt, height: 50pt, fill: pat)